Providers billing Medicare should determine if a patient is enrolled in hospice before billing Medicare Part A. This article has tips on checking patient eligibility and avoiding hospice claim rejects.
Once a claim is processed, Medicare decides to either pay or deny. However, in some situations, a decision to pay or deny isn’t possible because the claim has billing errors. First Coast returns these unprocessable claims back for you to correct and submit.
Effective October 1, First Coast will reject claims returned to a provider more than three times with reason code 70RTP. Read this article to learn more about this new reason code. Effective October 1, First Coast will reject claims returned to a provider more than three times with reason code 70RTP. Read this article to learn more about this new reason code.
First Coast would like to ensure providers performing biopsy services understand how to properly bill and code for these procedures. Recent data indicates improper billing so we want to provide clarification of top issues we identified.
Are you sending hardcopy mail to submit your requests to First Coast? Did you know there are faster and easier ways to send your requests to us? Avoid the wait. Learn about the electronic options available for you.
Last year, we implemented new P.O. Box addresses for mailing correspondence to First Coast. Make sure you are mailing to our current addresses as we’re no longer forwarding mail received at the old addresses. Visit our website for the new addresses.
CMS has identified a claims processing issue that potentially impacts all Cohort 1 Primary Care First (PCF) participants that submitted claims for flat visit fee (FVF) eligible services processed between January 1, 2021, and February 3, 2021.
Effective for dates of service (DOS) on/after August 7, 2019, Medicare will pay claims from approved providers for administration of autologous T-cells expressing at least one CAR for the treatment for cancer using administration HCPCS code 0540T. [MM12177]
Please review this reminder for billing the new condition codes (CCs) 90 and 91 issued by CMS under MM12049. First Coast revised this article to correctly reflect the effective date as claims received on or after February 1, 2021.
Are your claims being impacted because you have multiple PTANs linked to a single NPI? This article provides guidance for improving the efficiency of the NPI selection and may assist Medicare Part B providers with billing COVID-19 related services.
Most services billed to Medicare must reflect the exact date the service was performed for or provided to the patient. This article discusses situations where there have been questions from the provider community. [SE17023]
Transmittal 10486, dated November 19, 2020, is being rescinded and replaced by transmittal 10520, dated December 14, 2020, to revise the implementation date from December 14, 2020, to December 21, 2020. All other information remains the same. [CR11642]
The Centers for Medicare & Medicaid Services (CMS) recently issued the 2019 deductibles, coinsurance, and premium rates for beneficiaries covered through the Medicare fee for service program. [MM11025]
The interest period begins on the day after payment is due and ends on the day of payment. The new rate of 1.125 percent is in effect July through December 2020. [Publication 100-04, Chapter 1, Section 80.2.2]
Learn which modifier to use when you expect Medicare will deny a claim that does not meet medical necessity criteria and whether you have or do not have an advanced beneficiary notice (ABN) signed by the beneficiary.
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.